Central venous obstruction following pacemaker implantation is not uncommon and can prove challenging in the case of a system upgrade to a cardiac resynchronization therapy pacemaker (CRT-P). We describe the case of a patient who underwent a successful upgrading procedure of a pacemaker to a CRT-P in the presence of an occluded left subclavian vein and superior vena cava, using collateral veins that drained into right atrium.
Keywords: accessory hemiazygos vein; anchor balloon technique; azygos vein; cardiac resynchronization therapy (CRT); occluded left subclavian vein; snare.
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